We explored the association between groundwater radon levels and childhood cancer mortality in North Carolina. Using data from two state-wide surveys of public drinking water supplies, counties were...Full Text Available
Record production of heavy water was achieved: the plants at Glace Bay and Port Hawkesbury, Nova Scotia, produced a total of 560 megagrams. A shipment of 500 Mg was delivered on time to the Wolsung CANDU reactor in Korea. Energy conservation and waste hea...
Background An increasing number of people have access to the Internet, and more people are seeking tobacco cessation resources online every year. Despite the...Full Text Available
OBJECTIVE: To determine the household prevalence of firearms in Pennsylvania, and describe the storage practices for these weapons. DESIGN: A statewide telephone survey of 3,620 Pennsylvania adults...Full Text Available
... curricula and prototypical instructional materials have been emphasized. The program has provided ... materials are adapted and implemented on a state-wide basis. The laboratory materials and the text ...
Hydrological classification constitutes the first step of a new holistic framework for developing regional environmental flow criteria: the ?Ecological Limits of Hydrologic Alteration (ELOHA)?. The aim of this study was to develop a classification for 390 stream sections of the Segura River Basin based on 73 hydrological indices that characterize their natural flow regimes. The hydrological indices were calculated with 25?years of natural monthly flows (1980/81?2005/06) derived from a rainfall-runoff model developed by the Spanish Ministry of Environment and Public Works. These indices included, at a monthly or annual basis, measures of duration of droughts and central tendency and dispersion of flow magnitude (average, low and high flow conditions). Principal Component Analysis (PCA) indi...
The cumulative rate of childhood eczema during the first three years was studied in a birth cohort of 1265 New Zealand infants. A parental history of eczema was the strongest predictor of rates of childhood...Full Text Available
A major outbreak of penicillinase-producing Neisseria gonorrhoeae occurred in California beginning in late 1986. After a state public health emergency was declared in April 1987, a statewide, cooperative...Full Text Available
to end statewide burn ban 09/28/2011 - Commissioner's statement on $80 million biomass to jet fuel award to UW and WSU Media Center | View All News Meetings & Events Saturday Oct...
OBJECTIVE--To assess the accuracy of the ten questions screen as a measure of childhood disability for epidemiologic studies in populations lacking resources for professional assessment of children's...Full Text Available
Allergic rhinitis is common among children and quite often represents a stage of the atopic march. Although sensitization to food and airborne allergens may appear in infancy and early childhood, symptoms...Full Text Available
Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this...Full Text Available
Possible associations between environmental hazards and the occurrence of childhood leukemia were investigated in Woburn, MA, for the period 1969-79. Residents of Woburn were concerned over what they...Full Text Available
A case-control study has been carried out to examine the occurrence of childhood cancer in relation to the proximity of overhead power lines to a child's home address at birth and to the calculated...Full Text Available
This paper aims to highlight ways in which basic research findings in the field of childhood and adolescent depression can help to inform and refine preventive intervention efforts. We selectively review...Full Text Available
BackgroundBreast-feeding may affect the risk of developing allergy during childhood and may also cause exposure to immunotoxicants, such as polychlorinated biphenyls (PCBs), which...Full Text Available
Field data for validating plume models were collected in and around the Bull Run Steam Plant during two four-week periods between July and October, 1982. The field measurements were the second phase of the Plume Model Validation and Development (PMV and D) program. The Bull Run Steam Plant is located near Oak Ridge, Tennessee, and the area is described as the ''Moderately Complex Site'' to distinguish it from the ''Plains Site'' in eastern Illinois, which was the scene of the first phase of the PMV and D study conducted in 1980-81. The measurement program consisted of a set of meteorological, source, aerometric, and tracer measurements to track and characterize the plume. The tracer measurements constituted the largest portion of the total effort, and it involved the release of SF/sub 6/ tracer gas from the stack, and the sampling and analysis of nearly 64,000 air samples collected over a test ...
Increasing prosperity and population-growth in many developing countries are resulting in accelerated growth in population of vehicles and vehicle-kilometers traveled. In Pakistan also, the number of vehicles has jumped from 0.8 million to about 4.0 million within 20 years, showing an overall increase of more than 400%. Accordingly, the consumption of petrol (motor spirit) has increased from 828,670 metric tons to 1,189,042 metric tons. The high content of lead in petrol is a serious issue, as the end- product is the release of lead into the environment. In Pakistan, prior to July 2001, lead-content in petrol was reported to be as high as 0.35-0.84 gram per liter. The reported lead-levels in air (micrograms/cubic centimeter) in different cities of Pakistan are: Karachi (1980-81) 0.13-0.24; Peshawar (1994-95) 0.21-0.79; Lahore (1993-94) 0.15-8.36 and (1999-2000) 0.89-7.85 and Rawalpindi (1999-2000) 0.71-10.00, indicating the very alarming increase and high levels of ...
Developing markets in the Pacific Basin depend heavily on the production and export of consumer goods. The generation of hazardous waste as a by-product of industrial production can be linked to adverse health outcomes, such as childhood leukemia, in ways that are presently unknown. In California, exposures resulting from hazardous waste disposal are of concern in the etiology of childhood cancer. Approximately 63% of the 57 hazardous waste sites that the U.S. Environmental Protection Agency (USEPA) included in the national priority list under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) statute were in the six-county San Francisco Bay area. This area includes California`s Silicon Valley, where a disproportionate majority of these sites are located. Although only one study links hazardous waste disposal to childhood leukemia evidence is accumulating that in utero and maternal pesticide ...
... United States, there are 14 million people with diabetes and while most will not lose their vision ... good deal higher among people with Type I diabetes -- the type that usually begins in childhood and ...
Background:Spina bifida presents a significant cause of childhood morbidity in lower- and middle-income nations. Unfortunately, there is a paucity of literature examining...Full Text Available
BackgroundElementary schools represent both a source of childhood sun exposure and a setting for educational interventions.MethodsSun Protection...Full Text Available
High-risk neuroblastoma is a childhood malignancy with a poor prognosis. Gradual improvements in survival have correlated with therapeutic intensity, and the ability to harvest, process and...Full Text Available
Washington West Virginia Wisconsin Wyoming Cancer --- Choose a Cancer Site --- All Cancer Sites Bladder Brain & ONS Breast (Female) Breast (Female in situ) Cervix Childhood...
A letter of inquiry was sent to 21 countries in Europe to ascertain their experience of diphtheria during the last 20 years. An analysis of the 15 replies showed that all relied on childhood vaccination...Full Text Available
ObjectiveThe aims of the study were to: determine the attitudes of parents, pediatric residents, and medical students from a Turkish population toward childhood disciplinary methods; ascertain the association of participants' abusive childhood history with their attitudes toward discipline; and assess their attitudes about disciplinary actions, which should be reported as abuse.MethodA cross-sectional survey was conducted in Ankara University School of Medicine, Department of Social Pediatrics. Sixty-five parents, 39 pediatric residents, and 106 medical students completed a questionnaire (Survey of Standards of Discipline). This questionnaire was designed to measure sociodemographic characteristics, attitudes toward childhood disciplinary practices, and abusive childhood experiences. There...
Purpose - The purpose of this paper is to describe the processes and procedures utilized by Jacksonville State University's Houston Cole Library to digitize an oral history collection and provide access to it through the Library's catalog, web presence, and the state-wide digital repository initiative, Alabama Mosaic (see www.alabamamosaic.org). Design/methodology/approach - The paper is based on the Library's experiences in acquiring, digitizing, creating metadata for and making accessible a collection of oral histories. Findings - The paper describes the obstacles overcome, issues encountered, procedures established, and ramifications of the project. Practical implications - Many institutions are currently digitizing unique collections as part of repository initiatives, both institutiona...
Florida posseses climatic, land, and water resources favorable for abundant biomass production. Therefore, a statewide program has been initiated to determine adapted species for the available array of production sites. Plant resources under investigation include woody, aquatic, grasses, hydrocarbon, and root crop species. The goal is to produce a continuous stream of biomass for the various biofuel conversion options. Preliminary yields from energy cropping experiments range from about 10 to nearly 90 metric tons per hectare per year, depending on the crop and the production systems employed. (Refs. 15).
Since 1984 the Environmental Protection Agency (LfU) of the State of Baden-Wuerttemberg has been investigating the heavy metal burden of earthworms from representative long-term forest observation plots. These investigations are aimed at elucidating and assessing adverse effects of pollutants on the soil biocenosis. Methods: At first only lead and cadmium were measured in the worms; in repetitive measurements over the years further metals or metalloid elements such as aluminum, arsenic, chromium, cobalt, copper, manganese, mercury, nickel, thallium, vanadium, and zinc were added to the agenda. Results and conclusion: The frequency distribution of the metals in the earthworms was characterized statistically. For the first time state-wide background values, normal values and threshold values were established for all the elements measured. A comparable study with a similar range of parameters is known neither nationally nor internationally. Time trend studies have ...
Abstract Clonidine Extended Release Augmentation of Psychostimulants in ADHD ADHD a Risk Factor for Substance Abuse; Cognitive Deficits Not a Predictor Commentary on Kollins et al.; Clonidine XR Augmentation for ADHD Pharmacologic Treatment of Childhood Insomnias Effects of Guanfacine Extended Release on Alertness in ADHD Long Term ADHD Drug Treatment Bipolar Disorder Rates Similar Across Selected Countries Group CBT Alone or Group CBT Plus SSRIs in Childhood Anxiety Resolution of Quetiapine-Induced Oral Dyskinesia From the FDA
BackgroundPlasmodium falciparum morbid and fatal risks are considerably higher in areas supporting parasite prevalence ≥25%, when compared with low transmission...Full Text Available
BackgroundIndia experienced a rapid economic boom between 1991 and 2007. However, this economic growth has not translated into improved nutritional status among young Indian children....Full Text Available
BackgroundSome epidemiologic studies have suggested an association between electromagnetic field exposure induced by high voltage power lines and childhood leukemia, but null results...Full Text Available
OBJECTIVES: This article uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of residential magnetic field...Full Text Available
BackgroundExperimental psychology has only recently provided supporting evidence for Freud's and Janet's description of unconscious phenomena. Here, we aimed to assess whether specific...Full Text Available
School buses contribute substantially to childhood air pollution exposures yet they are rarely quantified in epidemiology studies. This paper characterizes fine particulate matter (PM2.5)...Full Text Available
BackgroundWhile prepubertal nutritional influences appear to play a role in sexual maturation, there is a need to clarify the potential contributions of maternal and childhood influences...Full Text Available
BackgroundSurrogate immunologic markers for natural and vaccine-mediated protection against tuberculosis (TB) have not been identified.MethodsHIV-infected...Full Text Available
Background:Childhood obesity is increasingly being observed with changing lifestyles of families. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges...Full Text Available
Mucopolysaccharidosis type IIIB (MPS IIIB; Sanfilippo syndrome type B) is a metabolic disorder with devastating clinical characteristics starting in early childhood and leading to premature death. A...Full Text Available
SummaryAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is most often diagnosed in childhood with symptoms often persisting into adulthood....Full Text Available
Ten patients in the age range 2 to 22 years are described who had operations initially for squint in childhood. Nine had had concomitant convergent strabismus and one divergent. All presented again...Full Text Available
BackgroundChildhood is a high risk time for ultraviolet induced skin damage as this age group has more time and opportunity to be outdoors in the sun. Children in Africa with the...Full Text Available
Dyslexia (or reading disability) and specific language impairment (or SLI) are common childhood disorders that show considerable co-morbidity and diagnostic overlaps and have been suggested to share...Full Text Available
Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by...Full Text Available
BackgroundImproving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies.MethodsA...Full Text Available
Physical activity and sedentary behavior are central components of lifetime weight control; however, our understanding of dimensions of these behaviors in childhood is limited. This study investigated...Full Text Available
BackgroundPoverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor...Full Text Available
This volume presents the collations tables of a six volume comparative epidemiological survey of the effects of low level radiation dose. Data are collated for the effects observed in the following irradiated groups:- Preconception irradiation, intra-uterine irradiation, childhood irradiation, adult irradiation. (UK).
Epidemiologic research concerning electric and magnetic fields in relation to cancer has focused on the potential etiologic roles of residential exposure on childhood cancer and occupational exposure...Full Text Available
Doxorubicin (DOX) is widely used in combination cocktails for treatment of childhood hematological cancers and solid tumors. A major factor limiting DOX usage is DOX-induced cardiotoxicity. However,...Full Text Available
The prevalent surge in childhood and adolescent obesity within the past 3 decades poses a significant challenge for many pediatric clinicians who are charged with treating this condition. The...Full Text Available
Diabetic pregnancies are characterized by chronic metabolic insults, including iron deficiency, that place the developing brain at risk and for memory impairment later in life. A behavioral...Full Text Available
Colorectal cancer is extremely rare in children. We report a case of a 12-year-old boy who presented with a five-month history of weight loss and anorexia, associated with vomiting episodes, dizziness,...Full Text Available
Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were...Full Text Available
Epidemiological studies could not show an association between ionising radiation of nuclear power stations in routine operation and the incidence of childhood cancer, yet. The following report presents a case control study conducted by the German Childhood Cancer Registry since autumn 2003. All children in the study region, who were diagnosed with cancer between 1980 and 2003 at an age below five are included. In the first part of the study we investigate whether children with cancer (cases) lived closer to the respective nuclear power stations compared to random children without cancer (controls). In the second part, for a subgroup of cases and controls we conduct computer assisted telephone interviews regarding confounders possibly associated with the exposure of ionising radiation and childhood cancer. Results are expected by the end of 2006. (orig.)
BackgroundChronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood....Full Text Available
OBJECTIVE--To determine whether the seeming excess of childhood leukaemia and lymphoma identified in Seascale, Cumbria, UK, remains unusual when put into a wider context. DESIGN--Analysis of cancer...Full Text Available
tumors make up two-thirds of all adult brain tumors and one-third of childhood brain tumors. Cancer Among Men, 2003-2007 Incidence rates decreased for lung, colorectal,...
Cancer stem cells (CSCs) have been identified in a number of solid tumors, but not yet in rhabdomyosarcoma (RMS), the most frequently occurring soft tissue tumor in childhood. Hence, the aim of this...Full Text Available
BackgroundHigh intake of sugar-sweetened beverages in childhood is linked to increased risk of obesity and type II diabetes later in life. Using three nationally representative surveys...Full Text Available
BackgroundEvolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic...Full Text Available
BackgroundWith rates of childhood obesity increasing, physical activity (PA) promotion especially in young children has assumed greater importance. Given the limited effectiveness...Full Text Available
Methylphenidate (MPH) is commonly prescribed in childhood and adolescence for the treatment of attention–deficit/hyperactivity disorders. In rodents, MPH exposure during preadolescence...Full Text Available
... 2010-10-01 false Child mental health. 1304.24 Section 1304.24 Public...HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION...AGENCIES Early Childhood Development and Health Services § 1304.24 Child...
The method, use and results of computer-aided diagnosis of bone tumours and tumour-like skeletal abnormalities in childhood are described. One hundred and twentyone histologically verified cases were analysed and subjected to computer-aided diagnosis. Statistical methods were used, resulting in an accuracy of 96.7% and 91.7% respectively. In order to obtain additional confirmation of the diagnosis, a so-called growth rate was calculated by the computer. This proved to be a reliable criterion for evaluating the biological behaviour of tumours, irrespective of the histological diagnosis. The reasons for misdiagnosis were discussed. Attention is drawn to the importance of an accurate analysis of the radiographs and its input into the computer.
The aetiology of childhood leukaemia remains generally unknown, although exposure to moderate and high levels of ionising radiation, such as was experienced during the atomic bombings of Japan or from radiotherapy, is an established cause. Risk models based primarily upon studies of the Japanese A-bomb survivors imply that low-level exposure to ionising radiation, including to ubiquitous natural background radiation, also raises the risk of childhood leukaemia. In a recent paper (Wakeford et al 2009 Leukaemia 23 770-6) we estimated the proportion of childhood leukaemia incidence in Great Britain attributable to natural background radiation to be about 20%. In this paper we employ the two sets of published leukaemia risk models used previously, but use recently published revised estimates of natural background radiation doses received by the red bone marrow of British children to update the previous results. Using the newer ...
In the present political climate, politicians are singling out children's programs and services for budget cuts. The need for teacher education programs to prepare early childhood teachers as children's advocates is becoming ever more evident. For years, the National Association for the Education of Young Children has called for greater involvement of early childhood educators as advocates for programs and services that promote children's health and education. In teacher education programs, however, this call has largely gone unheeded. The purpose of this article is to discuss the importance of involving teacher candidates in advocacy activities and policy research, the obstacles that teacher educators can face when incorporating advocacy components into their teacher education courses and programs, and resources and strategies they can use. This discussion builds upon a motivation-obstacles-resources framework developed for adoption of ...
Childhood anxiety is impairing and associated with later emotional disorders. Studying risk factors for child anxiety may allow earlier identification of at-risk children for prevention efforts. This study applied an ecological risk model to address how early childhood anxiety symptoms, child temperament, maternal anxiety and depression symptoms, violence exposure, and sociodemographic risk factors predict school-aged anxiety symptoms. This longitudinal, prospective study was conducted in a representative birth cohort (n = 1109). Structural equation modeling was used to examine hypothesized associations between risk factors measured in toddlerhood/preschool (age = 3.0 years) and anxiety symptoms measured in kindergarten (age = 6.0 years) and second grade (age = 8.0 years). Early child risk factors (anxiety symptoms and temperament) emerged as the most robust predictor for both parent-and child-reported anxiety outcomes and mediated the effects ...
Following the Chernobyl accident of April 1986, there has been a continual increase in the numbers of reported cases of childhood thyroid carcinoma. An EC-supported consortium to study the pathology and molecular biology of the thyroid cancers is being coordinated from the University of Cambridge. This paper reports the findings of this study so far, together with its recommendations for further studies. (author).
Atopic eczema is a chronic skin condition affecting between 5% and 20% of children aged up to 11 years at one time or other. Research suggests that prevalence is increasing and various environmental...Full Text Available
Low-level lead exposure during early childhood has long been associated with altered neurocognitive development and diminished cognitive functions. Over nine thousand U.S. industrial facilities...Full Text Available
Human parechovirus (HPEV) infections are very common in early childhood and can be severe in neonates. It has been shown that integrins are important for cellular infectivity of HPEV1 through experiments...Full Text Available
A review of main issues in diagnosing, complex treatment and prognosis of Ewing's sarcoma is presented. Current trend in chemotherapy, radiotherapy and surgery of the disease is discussed. Unfavourable prognosis is attributed to the systematic character of the disease, necessitating a complex therapeutic approach. Attempts to make an optimal combination of the three therapeutic methods in order to improve survival and reduce the rate of post-treatment complications are analyzed. 37 refs., 4 tabs. (author).
Based on the view that major changes in the social and economic context in the United States require major policy changes related to early childhood education, this paper examines the factors supporting public policy changes and how advocates for change in early childhood education might incorporate effective strategies. The paper is presented in two parts. Part 1 reviews the research on state policy settings and the factors that tend to support policy change. This part focuses attention on the ways that state policymakers appear to learn from what is going on elsewhere and incorporate new ideas into their policy agendas. Several strategic implications for advocates of policy change are presented, such as brainstorming a list of potential obstacles to the introduction of a policy innovation or shaping the debate so the public will support change. Part 2 of the paper takes these general strategic implications and considers their relevance to ...
Objectives To investigate whether maternal coffee and/or tea consumption during the last 6?months of pregnancy was associated with risk of childhood ALL. Methods Data on coffee and tea drinking during pregnancy from 337 case mothers and 697 control mothers were analyzed using unconditional multivariable logistic regression. A meta-analysis of our findings with those of previous studies was also conducted. Results There was little evidence of an overall association between maternal coffee consumption and risk of ALL: OR 0.89 (95% CI 0.61, 1.30), although there was some suggestion that higher levels of intake might increase the risk in children of non-smoking mothers: OR for 2+ cups/day?=?1.44 (95% CI 0.85, 2.42); this was supported by our meta-analysis. Risk was also elevated among cases wi...
2,3-Dimercaptosuccinic acid (DMSA) is a new orally active heavy metal chelator for the treatment of childhood Pb intoxication on an outpatient basis. The influence of DMSA, as well as other chelating agents, on gastrointestinal 203Pb absorption and whole-body "2"0"3Pb retention was examined. Groups of Sprague-Dawley rats (230-260 g) were gavaged with a solution containing approximately 25 mg/kg Pb [as Pb(NO_3)2] plus 15 microCi "2"0"3Pb. Some groups were then immediately given 0.11 mmol/kg of either DMSA, CaNa2EDTA, D-penicillamine, or BAL by oral gavage, while other groups received the same drugs by ip injection. Control groups received solutions of the drug vehicles po or ip. Whole-body Pb retention and gastrointestinal Pb absorption (whole body retention + urinary Pb excretion) were significantly decreased in rats that received DMSA po. This finding implies that the use of DMSA to treat childhood lead intoxication on an outpatient basis is ...
This article reviews antisocial personality disorder, psychopathy, and violence and develops a three factor model of personality traits. Then a discussion of related personality disorders precedes the development of a categorical two factor model of impulsive versus remorseless violence. A paradigm of proactive, medical, and school based early intervention and prevention is advocated as a useful addition to the reactive detention of criminal justice. Integration of psychological tests, neuroimaging, and genomic data in early childhood and school based intervention strategies to prevent the development of conduct disorder and attenuate criminal propensity inform this approach. PMID:20422651
Abstract Neurodegenerative and neurometabolic disorders may cause significant morbidity and mortality in children. Imaging is important in early diagnosis of metabolic disorders and in determining the extent of brain injury. Especially after the development of new techniques such as diffusion-weighted magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), neuroimaging plays more important role in the diagnosis and management of these disorders. In these disorders, usually a mutation causes a clinically significant block in one or more metabolic pathways. This blockage usually results in either a deficiency of the product or in an accumulation of substrate with damage induced by either storage or toxicity. The presenting symptoms are usually nonspecific. In some of the ...
We report the cranial CT and MRI findings in three children with Lyme disease (neuroborreliosis). The neuroimaging findings in children have been rarely reported. We found cranial MRI far superior to cranial CT. Ring-enhancing lesions have been described in acute disseminating encephalomyelitis and multiple sclerosis but not in neuroborreliosis. Although other infectious and inflammatory diseases cannot be excluded, Lyme disease should be included in the differential diagnosis and put forward as being the most likely diagnosis in the appropriate clinical setting. Gadopentetate dimeglumine is helpful in assessing the response to antibiotic treatment. (orig.)
Proton magnetic resonance spectroscopy (MRS) measures concentrations of metabolites in vivo and provides a powerful method for identifying tumours. MRS has not entered routine clinical use partly due to the difficulty of analysing the spectra. To create a straightforward method for interpreting short-echo-time MRS of childhood cerebellar tumours. Single-voxel MRS (1.5-T Siemens Symphony NUM4, TR/TE 1,500/30 ms) was performed at presentation in 30 children with cerebellar tumours. The MRS results were analysed for comparison with histological diagnosis. Peak heights for N-acetyl aspartate (NAA), creatine (Cr), choline (Cho) and myo-inositol (mIns) were determined and receiver operator characteristic curves used to select ratios that best discriminated between the tumour types. The method was implemented by a group of clinicians and scientists, blinded to the results. A total of 27 MRS studies met the quality control criteria. NAA/Cr >4.0 distinguished all but ...
Leukodystrophies are inherited white matter diseases due to abnormalities occurring in myelin synthesis and/or maintenance. The most common types of these rare childhood conditions are represented by adrenoleukodystrophy, metachromatic leukodystrophy, Canavan's, Alexander's, Krabbe's, and Pelizaeus-Merzbacher's diseases. Most of them are lethal during childhood, with the exception of the adrenoleukodystrophy-adrenomyeloneuropathy complex, which sometimes, during its early phases, may be cured with a dietary therapy. The aims of this paper are: 1) the description of inheritance factors, pathogenesis, pathological and clinical findings of each of the most frequent childhood leukodystrophies; 2) the description of the most common patterns of these conditions on CT and MR imaging; 3) the evaluation of the diagnostic capabilities of these two imaging techniques and the comparison of their results. Finally, some of the therapies ...
A study was performed to investigate the size of tongue area and intermaxillary space area, and compare the sexual differences between normal Korean children and adults by introducing planimetric and linear analysis of the lateral cephalograms. The cephalograms were composed of 41 child male aged 10.8, 40 child female aged 10.5, 38 adult male aged 21.3 , and 40 adult female aged 20.8 respectively. In order to study and measure the intermaxillary space area, the following were selected, as reference items: occlusal plane, anterior intermaxillary space height, posterior intermaxillary space height, length of intermaxillary space. Among those reference items anterior intermaxillary space height and posterior intermaxillary space height were perpendicular to the maxillary plane. An index, (Anterior intermaxillary space height + posterior intermaxillary space height )/2 Length of intermaxillary space, was introduced for the calculation of intermaxillary space area. While the tongue area was ...
The Kansas State Board of Education awarded $10.25 million to local education agencies through the Carl D. Perkins Vocational and Applied Technology Education Act of 1990. A work group developed the System of Measures and Standards of Performance (SMSP). Programs for single parents, displaced homemakers, and single pregnant women were funded to provide education/training, employment readiness, and job placement. Seven gender equity facilitator projects and 17 projects to provide young women access to training and support services for technical and nontraditional occupations were funded. Funding provided programs for criminal offenders in corrections institutions and special populations students. To promote state leadership and professional development, funds for curriculum development, inservice training, and vocational student organizations were awarded. Community-based organizations provided transitional programs, outreach programs, and other services for economically and ...
Populations living close to high-voltage transmission lines often have residential magnetic field exposures in excess of 1 [mu]T, and sometimes over 2 [mu]T. Yet, populations studied in most epidemiologic investigations of the association between residential magnetic field exposure and cancer typically have exposures below 1 [mu]T and frequently below 0.5 [mu]T. To improve statistical power and precision, it would be useful to compare high exposure populations with low exposure population. Toward this end, we have developed an automated method for identifying populations living near high-voltage transmissions lines. These populations likely have more highly exposed individuals that the population at large. The method uses a geographic information system (GIS) to superimpose digitized transmission line locations on U.S. Census block location data and then extract relevant demographic data. Analysis of data from a pilot study of the population residing within 100 m of a 29-km segment of ...
The object of this study was to identify those areas in California where synthetic fuel-fired power plants could be sited in the 1990 time frame, from an air quality perspective. The synfuel-fired power plants considered in this new study were 500 Mw methanol-fired combined cycle (MFCC) and 500 Mw integrated gasifier combined-cycle (IGCC) units. For comparison purposes, 500 Mw direct coal-fired boilers and 500 Mw natural gas-fired combined-cycle units were also considered. Staff did not attempt to locate plants at any specific sites, but relied primarily upon a regional countywide analysis. The study provides an approximation, for planning purposes, of a reasonable limit of the state's power plant siting capacity, given the plant types and sizes, conditions, and assumptions specified. The study shows that local emission limitations often preclude certain types of power plants (particularly direct-fired coal plants) even when they are equipped with Best Available Control ...
Those areas in California where synthetic fuel-fired power plants could be sited in the 1990 time frame, from an air quality perspective were identified. The synfuel-fired power plants considered in this new study were 500 MW methanol-fired combined cycle (MFCC) and 500 MW integrated gasifier combined-cycle (IGCC) units. For comparison purposes, 500 MW direct coal-fired boilers and 500 MW natural gas-fired combined-cycle units were also considered. The study provides an approximation, for planning purposes, of a reasonable limit of the state's power plant siting capacity, given the plant types and sizes, conditions, and assumptions specified. The study shows that local emission limitations many times preclude certain types of power plants even when they are equipped with Best Available Control Technology (BACT) as required by NSR regulations. This study also shows that 4000 MW of direct-fired coal plants could potentially be sited in California in compliances with all current ...
Urticaria is one of the most common dermatoses during the childhood, but it is very rare in the neonates. A 17-day-old infant with a generalized urticaria was admitted to our pediatric emergency unit. The mother of the infant reported having applied water boiled with stinging nettle (Urtica dioica) onto her nipples twice a day (before and after each breastfeeding) for 2?days in order to heal her nipple cracks. Serum total immunoglobulin E (IgE) and specific IgE levels for stinging nettle were high in the infant and the mother. The rashes began to regress within the first day of the hospitalization and disappeared completely on the second day without treatment. The skin prick test with the water boiled with stinging nettle was positive for the infant with significant induration, but not for...
This article examines relevant government policy documents on education and culture and discovers that Nigerian education authorities do not "discriminate" against art and culture in its articulation of educational policies per se, but lack of administrative machinery or political will has resulted in the deprivation of the Nigerian child in the process of creative activity in early childhood development. The article argues that lack of creative ability in our educational products is perhaps a major setback in the nation's quest for industrial and technological development. In this article a new art curriculum for elementary schools is advocated as a means of engaging the young child in order to attain functional educational skills necessary in the world of work.
This article argues the importance of ensuring initiatives aimed at improving children-s social and emotional well-being are based on sound participatory principles. The discussion posits links between the recognition of children, dialogic approaches to participation, changing conceptualisations of children and childhood, and children-s well-being. It explores these links in light of one particular initiative, Seasons for Growth (Graham, 1996, 2002, Seasons for Growth; Loss and Grief Education Program. MacKillop Foundation), an education programme built around emerging evidence that giving children a voice assists them to adapt to family change. The paper concludes with insights into what is involved when we locate notions of -having a say- as a key element in promoting children-s well-bei...
A large body of evidence indicates clear relationships between number and space processing in healthy and brain-damaged adults, as well as in children. The present paper addressed this issue regarding atypical math development. Adults with a diagnosis of dyscalculia (DYS) during childhood were compared to adults with average or high abilities in mathematics across two bisection tasks. Participants were presented with Arabic number triplets and had to judge either the number magnitude or the spatial location of the middle number relative to the two outer numbers. For the numerical judgment, adults with DYS were slower than both groups of control peers. They were also more strongly affected by the factors related to number magnitude such as the range of the triplets or the distance between t...
Despite high local control rate in Ewing's sarcoma the exact indication of radiation therapy is still controversial as well as the choice of the target volume and the optimal dose of radiation. The importance of the quality of radiotherapy has been stressed in recently published data and has shown a significant impact on long term local control with adequate radiation therapy. The dramatic improvement of precision allowed by the conformal therapy and three dimensional dosimetry allow to expect a decrease of late effects expected for second malignancies. However, late sequelae and radio-induced osteosarcoma still remain the major side effects after radiotherapy. The authors discuss the results of the main trials on Ewing's sarcoma on the choice of dose and target volume. Surgery is still the preferred choice for small tumors if the foreseen outcome is identical. (authors). 28 refs.
Childhood cancer survivors at highest risk of developing a secondary malignancy are those with hereditary retinoblastoma. The majority of such secondary cancers will be sarcomas, most commonly of bone. One-third of these occur outside a typical radiation field, commonly in an extremity. Bone sarcoma is also the most commonly reported secondary cancer to develop among survivors of Ewing's sarcoma. In this group, radiation doses greater than 60 Gy as well as alkylating agent chemotherapy have been identified as contributors to the increased risk. The prognosis for patients with a secondary sarcoma has been poor, with few cures reported to date. However, an aggressive, combined modality approach, including radical resection, postoperative radiation, and adjuvant chemotherapy, may improve the survival rate.
Abstract Background The increase in the incidence of atopic dermatitis (AD) in developed countries has been related to familiar and environmental factors. This survey was undertaken to investigate the family background, birthweight and the home environment of children suffering from AD in order to point out the possible factors that provoke the development of the disease. Methods The study uses data collected by means of self-administered questionnaires and discusses 461 cases of children (age 0-12) with active skin signs of AD. The control group comprised of 343 children (age 0-12) with no skin signs or positive lifetime history of AD. Associations between familiar and various home environmental factors and the risk of AD were calculated by means of odds ratios. Results There were statist...
Abstract- In our reply to M. H. van IJzendoorn and M. J. Bakermans-Kranenburg (this issue) and R. A. Thompson (this issue), we highlight 2 challenges that attachment researchers face today: (a) closing the gap between the developmental and social psychological traditions and (b) connecting attachment theory to the broader field of evolutionary psychology. We contend that an evolutionary life history approach can contribute to both goals and argue that attachment researchers should consider moving beyond some of Bowlby's original formulations in order to permit further advancement of the field. Finally, we review van IJzendoorn and Bakermans-Kranenburg's criticism of the hypothesis that sex differences in attachment arise in middle childhood; we conclude that the claim that the hypothesis h...
Abstract Intense controversy surrounds the management of disorders of sex development, particularly in relation to the validity of parental consent for genital surgery and the removal of gonadal tissue carried out during infancy or childhood. Past practices have been heavily criticised on ethical grounds by patient advocacy organisations, who have demanded a moratorium on these kinds of operations unless authorised by a court. Some doctors and hospital administrators have been influenced by the controversy and have referred cases to the Family Court of Australia, where a series of judgements have now established legal precedents that apply across Australia, restricting the circumstances in which parents can give consent for surgery. An alternative approach is to use a hospital-based Clinic...
Objective: Analyse the difference in school careers and secondary school qualification levels between unilateral hearing aid users and bilateral hearing aid users. Study design: Retrospective questionnaire study. Setting: Postal-based questionnaire. Participants: Names of adults known to have been fitted with unilateral or bilateral hearing aids during childhood were retrieved. This resulted in 292 names. Participants were selected using the following criteria: availability of the medical record, presence of bilateral hearing loss, completed secondary school education, normal IQ and a minimum aided word-recognition score of 70% at 10 years of age. The questionnaire was sent to 50 potential participants of whom 40 responded, resulting in two groups comprising 19 unilateral and 21 bilateral ...
The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)
Brain tumor was diagnosed by computer tomography or magnetic resonance imaging in 100 children aged 0 to 19 years. They consecutively underwent primary surgical treatment during the years 1984 to 1988. Non-neoplastic lesions and operations for residual tumors are not included. 54 tumors were localized supratentorially. 72% of these were benign og low grade malignancies. 46 tumors had an infratentorial localication. 59% of these were high grade malignancies. Children tolerate major-neurosurgical procedures better than adults and restitution is usually favourable. 42 children with high grade malignancies underwent postoperative radiotherpy. Per- and postoperative mortality in this series was 1%. 80 children are alive. 62 of these are in excellent condition after a median observation time of 40 months. 10 refs.
Background and aims. The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia. We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination, as compared to usual care, in 4- to 12-year-old children. Methods. In all, 239 children were enroled by 25 family practitioners in an open-label study. After a pseudo-randomization, usual pain management (n = 132) was compared to a multifactorial strategy (n = 107) associating preliminary application of an anesthesic patch, preferential use of specified vaccines, child education by the parents and the doctor, parental accompaniment...
At the end of 2005, Robert D. Felner was riding high. A well-paid dean at the University of Louisville, he had just secured a $694,000 earmarked grant from the U.S. Department of Education to create an elaborate research center to help Kentucky's public schools. The grant proposal, which Mr. Felner had labored over for months, made some impressive promises. On paper this all seemed plausible: From 1996 until 2003, Mr. Felner directed the University of Rhode Island's education school, where he helped create a well-regarded statewide research center. To put it gently, Mr. Felner did not duplicate that feat at Louisville. By the spring of 2008, all but $96,000 of the grant had been spent, but none of the tasks listed in Mr. Felner's proposal had been accomplished. Late in May 2008, he told his colleagues that he had been hired as chancellor of the University of Wisconsin-Parkside, effective August 1. During his final weeks at Louisville, Mr. Felner pressed his luck ...
The diagnosis of idiopathic pulmonary hemosiderosis (IPH) may be elusive. A 6-year-old boy had microcytic hypochromic anemia and a hemolytic component. Hemosiderin-laden macrophages were not found in the gastric aspirate. He had no pulmonary signs or symptoms. Extensive hematologic and roentgenologic investigations failed to reveal the cause of the anemia. Quantitative serial scintigraphic scanning showed significant (35%) pulmonary sequestration of autologous erythrocytes labeled with sodium chromate Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy spece Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy specimen confirmed the diagnosis of IPH. A diagnosis of IPH should be considered when children have iron deficiency anemia and pulmonary signs or symptoms. Organ sequestration studies may be helpful in equivocal cases.
Purpose We assess the outcome in 46,XX men with congenital adrenal hyperplasia who were born with Prader 4 or 5 genitalia and assigned male gender at birth. Materials and Methods After receiving institutional review board approval and subject consent we reviewed the medical records of 12 men 35 to 69 years old with 46,XX congenital adrenal hyperplasia, of whom 6 completed social and gender issue questionnaires. Results All subjects were assigned male gender at birth, were diagnosed with virilizing congenital adrenal hyperplasia at age greater than 3 years and indicated a male gender identity with sexual orientation to females. Ten of the 12 subjects had always lived as male and 2 who were reassigned to female gender in childhood subsequently self-reassigned as male. Nine of the 12 men had ...
Kidney length (KL), renal area and renal parenchymal area were measured on i.v. urograms of 255 children without apparent kidney disease age 0 to 14 years. These parameters were compared with age, body height, body surface area and the distance between the 1sup(s)sup(t) and 4sup(t)sup(h) lumbar vertebral body. In addition, renal parenchymal thickness was determined at the upper and lower poles. Mean values for normal KL were significantly greater on the left side than on the right side requiring separate growth charts. A mean increase in KL of 6.3 mm for the left and 6.0 mm for the right kidney was calculated for a change of 10 cm body height. A small kidney is defined by a KL below -2 SD for the corresponding body height and/or a quotient of right KL/left KL outside +-2 SD from the mean value. Localised loss of renal parenchyma is reflected by an increased or decreased quotient of the upper to the lower polar thickness and reduction of total kidney mass by a diminished bipolar ...
Kidney length (KL), renal area and renal parenchymal area were measured on i.v. urograms of 255 children without apparent kidney disease age 0 to 14 years. These parameters were compared with age, body height, body surface area and the distance between the 1sup(s)sup(t) and 4sup(t)sup(h) lumbar vertebral body. In addition, renal parenchymal thickness was determined at the upper and lower poles. Mean values for normal KL were significantly greater on the left side than on the right side requiring separate growth charts. A mean increase in KL of 6.3 mm for the left and 6.0 mm for the right kidney was calculated for a change of 10 cm body height. A small kidney is defined by a KL below -2 SD for the corresponding body height and/or a quotient of right KL/left KL outside +-2 SD from the mean value. Localised loss of renal parenchyma is reflected by an increased or decreased quotient of the upper to the lower polar thickness and reduction of total kidney mass by a diminished bipolar ...
Gonadal function was studied in two groups of children previously treated for medulloblastoma with surgery followed by postoperative craniospinal irradiation. In group 1 but not in group 2, the children also received adjuvant chemotherapy for one to two years. All children in group 1 received a nitrosourea (BCNU or CCNU), plus vincristine in four and procarbazine in three patients. The nine children in group 1 showed clinical and biochemical evidence of gonadal damage with elevated serum FSH concentrations and, in the boys, small testes for their stage of pubertal development. In group 2 (n . 8), each child had completed pubertal development normally, the boys had adult sized testes and the girls regular menses. Gonadotropin values were normal in all eight children. We conclude that nitrosoureas were responsible for the gonadal damage in the children in group 1, with procarbazine also contributing to the damage in the three children who received this drug. In view of the limited proved ...
MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic segmental approach ...
Ionizing radiation dose levels due to home radon can rise to levels that would be illegal for workers in the nuclear industry. It is well known that radon levels within homes and from home to home, and also from month to month, vary considerably. To define an Isle of Man radon seasonal correction factor, readings were taken in eight homes over a 12 month period. An average island indoor exposure of 48 Bq m{sup -3} (range 4-518 Bq m{sup -3}) was determined from 285 homes selected from a cohort of 1300 families participating in the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) in the Isle of Man. This compares with a UK home average of 20 Bq m{sup -3} and a European Union average (excluding UK) of 68 Bq m{sup -3}. Ten homes of those measured were found to have radon levels above the National Radiological Protection Board 200 Bq m{sup -3} action level. There are 29 377 homes on the Isle of Man, suggesting that there could be some 900 or more homes ...
Purpose: The aim of this study was to demonstrate the typical appearance of ganglioneuromas in computer-assisted tomography (CT), and magnetic resonance imaging (MRI). Material and methods: Retrospective analysis of diagnostic imaging (9 CT, 6 MRI) in 9 children aged 3 to 15 years with the histological diagnosis of ganglioneuroma. Results: The tomographies showed large (max. 13.4 cm in diameter) round or oval tumors with sharp delineation. The sites of the tumors were the retroperitoneum (5), the mediastinum (3), and the adrenal gland (1). Intraspinal tumor involvement occurred in 4 cases. On comparing CT with MRI, MRI was more accurate in defining the intraspinal involvement. The ganglioneuromas were of hypodense appearance in the native CT scan and showed moderate enhancement upon administration of contrast media. In five patients tumor calcifications with a disseminated sprinkled pattern were seen in CT. In MRI T_1-weighted scans the tumors were homogeneous and hypointense, after ...
Attention deficit hyperactivity disorder (ADHD) is known as a psychiatric disorder in childhood associated with dopamine dysregulation. We investigated dopamine transporter (DAT) density in children with ADHD in the present study using {sup 123}I-IPT SPECT and postulated that an alteration in DAT density in the basal ganglia (BG) is responsible for dopaminergic dysfunction in children with ADHD. 9 durg-naive children with ADHD and 6 normal children were included in the study. We performed brain SPECT 2 hours after administration of {sup 123}I-IPT and made both quantitative and qualitative analyses for assessment of specific/nonspecific DAT binding ratio in the BG. We investigated the correlation between the severity scores of ADHD symptoms in children with ADHD assessed with ADHD rating scale and specific/nonspecific DAT binding ratio in the BG. Drug-naive children with ADHD showed a significantly incresed specific/nonspecific DAT binding ratio in the BG compared ...
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare services, suggesting that somatisation does not play a major role in children with chronic benign pain. PMID:12030664
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give satisfactory ...
Purpose: To describe CT appearances in patients with unilateral cleft lip and palate (CLP) 20 years after bone graft surgery. Material and Methods: Eighteen consecutive patients with unilateral CLP were examined. All patients had been treated with primary closure, both in infancy and early childhood, supplemented with bone grafting at the age of around 10 years. The CT examination of the upper jaw included a dental CT program. The CT appearances of the cleft side were compared with those of the untreated non-cleft side. Results: Abnormal CT appearances included skew nasal aperture (n=17), nasal septal deviation (n=17), low floor of nasal aperture (n=15) at or towards the cleft side, and deviation of anterior nasal spine towards the non-cleft side (n=18). The posterior part of the bone cleft was visible in all patients, and the dental arch was V-shaped in 8. Conclusion: Although adherence to the present treatment protocol is considered to give satisfactory ...
In its 1990 recommendations, the ICRP considered the radiation risks after exposure during prenatal development. This report is a critical review of new experimental animal data on biological effects and evaluations of human studies after prenatal radiation published since the 1990 recommendations. Thus, the report discusses the effects after radiation exposure during pre-implantation, organogenesis, and fetogenesis. The aetiology of long-term effects on brain development is discussed, as well as evidence from studies in man on the effects of in-utero radiation exposure on neurological and mental processes. Animal studies of carcinogenic risk from in-utero radiation and the epidemiology of childhood cancer are discussed, and the carcinogenic risk to man from in-utero radiation is assessed. Open questions and needs for future research are elaborated. The report reiterates that the mammalian embryo and fetus are highly radiosensitive. The nature and sensitivity of ...
Pulmonary tumors in children are rare. Nevertheless, there are besides malign primary neoplasms and metastases also some benign tumors that the radiologist should know. The identification of some tumors is difficult, since some of them may mimic pulmonary inflammation. The first diagnostic tool is chest radiography. After that, a CT with contrastmedium should be performed, if possible a multislice-CT (MSCT). Identification of mediastinal structures is best with MRI. (orig.) [German] Tumoren der Lunge sind im Kindesalter selten. Trotzdem finden sich neben den malignen primaeren und sekundaeren Raumforderungen auch im Kindesalter immer wieder benigne Tumoren, die der Radiologe kennen sollte. Eine eindeutige Identifizierung kann schwierig sein, da z. B. entzuendliche Infiltrate vorgetaeuscht werden koennen. Die primaere Untersuchungsmethode ist das konventionelle Thoraxroentgen. Die weitere Diagnostik muss mit der Computertomographie, nach Moeglichkeit mit einem ...
Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors cisplatin containing chemotherapies in ...
Preliminary psychometric properties of a new instrument, Angie/Andy Cartoon Trauma Scales (ACTS), are presented. Angie/Andy features a cartoon-based methodology, measuring trauma-related sequelae of prolonged, repeated abuse. A sample of 208 children comprised intrafamilial trauma, extrafamilial trauma, combined trauma, and nontrauma groups. Angie/Andy demonstrated high internal consistency, with coefficient alphas from 0.70 to 0.95. The three trauma groups scored significantly higher than the nontrauma group on all scales (p's < 0.0001). Generally, the most severely traumatized group scored significantly higher than the less severely traumatized groups. The number of types of violence exposures correlated with Angie/Andy scores from 0.55 to 0.74. The frequency and severity of trauma exposure correlated with Angie/Andy scores from 0.44 to 0.56. The Angie/Andy parent version correlated with a standardized parent scale from 0.71 to 0.81. Parent/child agreement was significant. ...
Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach will mandate the ...
Two children with cutaneous lymphoma and leukemia who were treated with total skin electron beam therapy (TSEB) are described here. Patient 1. A 7-year-old boy was admitted because of a mass over the bilateral parotis and anemia. The white blood cell count on admission was 5,000/ul. Bone marrow examination revealed 70 per cent monoblasts (M5a type by FAB classification). Complete remission was obtained following the regimen of daunomycin, cytosine arabinoside, 6-mercaptopurine and prednisolone. He was again admitted because of a skin nodule on the left thigh 19 months after initial diagnosis. A biopsy of the skin nodule demonstrated monoblastic infiltration. He received 20 Grays (Gy) to the left thigh and this led to resolution of the skin nodule. At that time, other skin nodules appeared on the right upper and lower extremities. He was treated with TSEB. Daily doses of 1 Gy were given twice a week with a 4 MeV electron beam and a total dose of 10 Gy was administered over a period of 4 ...
To assess the utility of magnetic resonance (MR) imaging in the study of pediatric patients with clinical suspicion of pituitary disease. We studied 18 patients aged 7 to 18 years.Fifteen had hormonal disturbances, two presented amenorrhea and 1 complained of headache, fever and symptoms of polyuria and polydipsia. All the patients were examined using a Siemens SP 42 1-Tesla MRI scanner. Sagittal and coronal T1-weighted spin-echo images were obtained; in addition T2-weighted spin-echo or fast spin-echo imaging was performed in ten cases and intravenous gadolinium was administered in nine. We found 9 patients with hypothalamic-pituitary dysgenesis, 2 with germinoma, 2 cases of pituitary hemosiderosis in patients with thalassemia, 2 cases of microadenoma, one abscess, one case of idiopathic central diabetes insipidus and one of Langerhans cell histiocytosis. MR enabled us to assess pituitary structural alterations in children with hypothalamic-pituitary hormone deficiencies. In our ...
The majority of experimental and population studies of blood lead (PbB) and environmental lead, including the Omaha study, have utilized the Goldsmith-Hexter log-log or power function model. Comparison was made of the log-log model and a linear model of total exposure as they described the Omaha Study of 1074 PbBs from children ages 1-18 years as related to air (PbA), soil (PbS), and housedust (PbHD) lead. The data fit of the linear model was statistically equivalent to the power model and the predicted curves were biologically more plausible. The linear model avoids the mathematical limitations of the power model which predicts PbB zero at PbA zero. From the Omaha data, this model, ln PbB = ln (..beta../sub 0/ + B/sub 1/ PbA + B/sub 2/ PbS + ..beta../sub 3/ PbHD) predicts that PbB increases 1.92 ..mu..g/dl as PbA increases 1.0 ..mu..g/m/sup 3/. Since PbS and PbHD increase with PbA, however, the increases in total exposure predict a PbB increase of 4-5 ..mu..g/dl as PbA increases 1.0 ...
Transducin {alpha} subunits are members of a large family of G-proteins and play an important role in phototransduction in rod and cone photoreceptors. We report the localization of the human cone {alpha} transducin (GNAT2) gene using fluorescence in situ hybridization (FISH) on chromosome 1 in band p13. The recent assignment of a gene for Stargardt`s disease to the same chromosomal region by linkage analysis prompted us to investigate the possible role of GNAT2 in the pathogenesis of this disease. Stargardt`s disease is characterized by degeneration in late childhood or early adulthood of the macula of the retina, a region rich in cones. We screened patients with Stargardt`s disease, with or without peripheral cone involvement as monitored by the full-field ERG, for mutations in this gene. We investigated 66 unrelated patients including 22 with peripheral cone dysfunction for mutations in the coding region of the GNAT2 gene using polymerase chain reaction-single ...
Stargardt`s disease (MIM 248200), originally described in 1909, is an autosomal recessive condition of childhood, characterized by a sudden and bilateral loss of central vision. Typically, it has an early onset (7 to 12 years), a rapidly progressive course and a poor final outcome. The central area of the retina (macula) displays pigmentary changes in a ring form with depigmentation and atrophy of the retinal pigmentary epithelium (RPE). Perimacular yellowish spots, termed fundus flavimaculatus, are observed in a high percentage of patients. We have recently reported the genetic mapping of Stargardt`s disease to chromosome 1p13. On the other hand, considering that fundus flavimaculatus (MIM 230100) is another form of fleck fundus disease, with a Stargardt-like retinal aspect but with a late-onset and a more progressive course, we decided to test the hypothesis of allelism between typical Stargardt`s disease and late-onset autosomal recessive fundus flavimaculatus. ...
The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers were visited by 11.5, 2.8, and 4.0%, respectively. In the preceding year, 6.4% had been hospitalized due to pain. The most important factors linked to utilizing medical services were ...
In this paper we present an overview of the literature on efficacy and safety trials of the various pneumococcal conjugate vaccines on the market (PCV7) and in development (PCV9, PCV11 and allegedly PCV10 and PCV13), as well as of observations from post-licensure studies. Seven- (PCV7) and nine-valent PCV (PCV9) are reported to be sufficiently immunogenic after administration of a 3+1 schedule in infants in various RCTs. PncOMPC (PCV7 with a protein of N. meningitidis as a carrier) is less immunogenic, though this may have no repercussions for the protective efficacy against clinical disease. PCV7 is 82-97% efficacious against vaccine serotype (VT) IPD, 90% efficacious against (clinically diagnosed) pneumococcal pneumonia, and, like the 11-valent PCV, 57% efficacious against VT acute otitis media. Naturally, it would be of paramount public health interest if the same levels of efficacy and effectiveness could be achieved with fewer doses. Trials studying 2+1 vaccination schedules for ...
The /sup 13/C-AP breath test is shown to be a convenient, noninvasive method to monitor velocity and capacity of P450-dependent AP N-demethylation in infancy and childhood. According to /sup 13/C-AP breath tests, neonates have a very low capacity to eliminate /sup 13/CO/sub 2/, which is only 15 to 21% of the activity in adults. During the first year of life AP N-demethylation increases to reach its maximum at about 2 years; afterwards a slight decrease occurs. In 25 neonates exposed prenatally to different antiepileptic drugs /sup 13/C-AP breath test was efficiently used to prove that cytochrome AP N-demethylation was considerably stimulated. After primidone/phenobarbitone, especially in combination with phenytoin, /sup 13/C elimination reaches and even surpasses the range for older children. Valproate exposure during fetal life is not consistently followed by a significant increase in AP N-demethylation. The enzyme induction demonstrated by /sup 13/C-AP breath ...
Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N-(3-iodopropen-2-yl) -2-carbomethoxy-3beta-(4-chlorphenyl) tropane (I-123 IPT) SPECT in children with ADHD before and after methylphenidate treatment. Nine drug-naive children with ADHD and seven normal children were included in the study. We performed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of specific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed (123I)IPT SPECT after treatment with methylphenidate (0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ...
Attention deficit hyperactivity disorder (ADHD) is a psychiatric disorder in childhood that is known to be associated with dopamine dysregulation. In this study, we investigated dopamine transporter (DAT) density in children with ADHD using iodine-123 labelled N-(3-iodopropen-2-yl)-2β-carbomethoxy-3β-(4-chlorophenyl) tropane ([{sup 123}I]IPT) single-photon emission tomography (SPET) and postulated that an alteration in DAT density in the basal ganglia is responsible for dopaminergic dysfunction in children with ADHD. Nine drug-naive children with ADHD and six normal children were included in the study. We performed brain SPET 2 h after the intravenous administration of [{sup 123}I]IPT and carried out both quantitative and qualitative analyses using the obtained SPET data, which were reconstructed for the assessment of the specific/non-specific DAT binding ratio in the basal ganglia. We then investigated the correlation between the severity ...
Regional cerebral blood flow (rCBF) was assessed with single photon emission computed tomography (SPECT), "1"2"3I-N-isopropyl-iodoamphetamine ("1"2"3I-IMP), and the Table-Look-Up method in 51 children (27 boys, 24 girls) considered neurologically normal and aged 1 month to 15 years (mean age, 4 years 1 month; standard deviation (SD) 3 years 11 months) divided into seven age groups. The rCBF was measured in cortical regions, the cerebellum, thalamus, and the head of the caudate nucleus. Curves for reference values and standard deviations were defined for each region. The rCBF rapidly increased until 2 years of age, reaching maximum values during the third to fifth periods (2 to 10 years of age) in each region. The rCBFs then decreased, reaching adult levels at 10 to 15 years of age. The rCBF reached maximum values later in the frontal region than in other regions. The rCBF during the early period increased most prominently in the occipital region. These results reflect anatomical ...
A Task Group of the International Commission on Radiological Protection (ICRP) has finished a report Biological Effects after Prenatal Irradiation (Embryo and Fetus) which has been approved by the Main Commission and Will be Published. Some new important scientific data shall be discussed in this contribution. During the preimplantation period lethality of the mammalian embryo is the dominating radiation effect. However, in mouse strains with genetic predispositions it has been shown that also malformations can be caused. This effect is genetically determined and its mechanisms is different from the induction of malformations during major organogenesis. Radiation exposures during this prenatal period leads ato an increase of genomic instability of cells in the normal appearing fetuses. These radiation effects can be transmitted to the next generation. A renewed analysis of individuals with severe mental retardation after exposures during the 8th to 15th week post conception in ...
As a central supervision authority the National Electrical Safety Board (Elsaekerhetsverket) has the main responsibility for the safety of high voltage power lines and other power electric equipment. It is therefore also responsible for questions concerning the effects of power frequency magnetic fields on the environment. According to the rules it is not allowed to draw overhead power lines with a voltage exceeding 1000 V above buildings. Their minimum distance to buildings must not be below 5 m. For regions comprised by rural development plans the directions prescribe a minimum distance of 10 m between buildings and high voltage transmission lines with a voltage of 55 kV or more. The publication of two large epidemiological studies about exposure to magnetic fields and cancer in Sweden in autumn 1992 has brought magnetic fields problems to general notice again. A statement on health risks form electromagnetic fields was issued by SSI in January 1993. SSI and Elsaekerhetsverket ...
Characterisation of the classification of brain tumours authorised by the WHO. Method of appraisal: This classification was revised and published in its second version. In the revision, some tumours were regrouped histogenetically and some tumour variants were added. Radiologically relevant changes of the classification include the differentiation of four new tumour entities that are easily distinguished by MR imaging. These four tumours belong to the group of childhood tumours or tumours occurring in early adulthood and are characterized by a good prognosis after extirpation. Results of appraisal: Central neurocytomas are small-cyst ventricular tumours associated with the foramen of Monroi and show moderate contrast enhancement. Infantile desmoplastic gangliogliomas/astrocytomas commonly consist of a solid tumour portion related to the leptomeninges with pronounced contrast enhancement and a typically very large cyst. Pleomorphic xanthostrocytomas are ...
To determined precisely a possible connection between the amount of copper in tap-water and the risk of early childhood liver disease, it was attempted through an epidemiological survey, to determine the extent of excessive concentrations of copper in the tap-water of households with copper pipes. Water samples from 956 households were tested for copper, and the state of health of the infants in these households was documented. Infants who had been fed using water with a copper concentration of 0.8 mg/l or more received a paediatric examination with a blood serum analysis to rule out any liver damage. A copper level greater than 0.8 mg/l was found in only 2% of the households examined. Eight infants were examined by a paediatrician and their serum was analysed. These infants had either been breast-fed to the 12th week or had received more than 200 ml of tap water per day during first 12 months. None of the infants examined showed any signs of liver malfunction. ...
MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic segmental approach ...
Purpose: The aim of this study was to demonstrate the typical appearance of ganglioneuromas in computer-assisted tomography (CT), and magnetic resonance imaging (MRI). Material and methods: Retrospective analysis of diagnostic imaging (9 CT, 6 MRI) in 9 children aged 3 to 15 years with the histological diagnosis of ganglioneuroma. Results: The tomographies showed large (max. 13.4 cm in diameter) round or oval tumors with sharp delineation. The sites of the tumors were the retroperitoneum (5), the mediastinum (3), and the adrenal gland (1). Intraspinal tumor involvement occurred in 4 cases. On comparing CT with MRI, MRI was more accurate in defining the intraspinal involvement. The ganglioneuromas were of hypodense appearance in the native CT scan and showed moderate enhancement upon administration of contrast media. In five patients tumor calcifications with a disseminated sprinkled pattern were seen in CT. In MRI T{sub 1}-weighted scans the tumors were homogeneous and hypointense, ...
Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder of early childhood onset. Defining symptoms are chronic impairments of attention, impulse control and motor hyperactivity that frequently persist until adulthood. Miscellaneous causes of the disorder have been discussed. Accumulating evidence from imaging- and molecular genetic studies strengthened the theory of ADHS being a predominantly inherited disorder of neurobiological origin. In the last 15 years, non-invasive brain imaging methods were successfully implemented in pediatric research. Functional magnetic resonance imaging studies gave major insight into the neurobiological correlates of executive malfunction, inhibitory deficits and psychomotoric soft signs. These findings are in good accordance with brain morphometric data indicating a significant volumetric decrease of major components of striato-thalamo-cortical feedback loops, primarily influencing prefrontal executive ...
Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors cisplatin containing chemotherapies in ...